FAIR Health Offers Expanded Datasets and Support for Workers’ Compensation Programs
August 15, 2024
State workers’ compensation programs are increasingly interested in providing fee schedule values for services they have not included in fee schedules in the past. FAIR Health is assisting them by offering expanded datasets and support for areas such as dental services, ambulatory surgery centers (ASCs) and health services provided in the home.
Many state workers’ compensation programs base their fee schedules on Medicare, but Medicare has gaps in the services it covers, such as dental care. Medicare generally does not cover dental services, so many workers’ compensation fee schedules do not have a source for dental fees. Many states license our trusted dental benchmarks and use our support to create dental fee schedules.
Some states reimburse ASCs the same as they do outpatient hospital facilities, while others reimburse ASCs at different levels. FAIR Health has been assisting state programs to evaluate information to help inform decisions on multiple methodologies for developing rates for ASC services.
Another example of using FAIR Health’s data and support is with home healthcare services. While Medicare covers home care services, it does not include pricing in their fee schedules. Commercial data from FAIR Health can be helpful in establishing reimbursement levels for services provided in the home.
States that we have worked with in these areas include Georgia, Kentucky, Mississippi, Oklahoma and Tennessee. In addition, a number of states license FAIR Health data to assist in their internal fee schedule evaluations.
Recent Fee Schedules
Expanded datasets are one part of the support FAIR Health provides to workers’ compensation programs. In addition to licensing data to support fee schedule development, FAIR Health also provides support to develop and distribute the fee schedules. Recently, we assisted states with several newly released fee schedules.
On April 1, Georgia and South Carolina released their 2024 fee schedules and Tennessee made rate tables available for the first time. We assisted these states with developing and updating rate tables, and, in the cases of Georgia and South Carolina, updating guidelines and policies as well.
In addition to these three states, we assisted Arizona, Kentucky and Oklahoma with developing and updating 2024 fee schedule ground rules and rate tables. Arizona’s fee schedule was released on May 1 and those of Kentucky and Oklahoma on July 1.
New Workers’ Compensation Clients
The list of state workers’ compensation programs that FAIR Health assists has been growing. New additions this year include New Mexico and Wyoming. New Mexico and Wyoming are using our data to gap fill their fee schedules for services not priced by Medicare, and Wyoming is also using FAIR Health dental data to develop its fee schedule.
FAIR Health President Robin Gelburd stated: “We are pleased to be able to assist so many states with their workers’ compensation programs. With our experience and expertise, our flexible, trusted, neutral approach allows us to tailor our support and assistance to the particular needs of each state.”
For more information on how FAIR Health’s data support state workers’ compensation programs, contact us by email at info@fairhealth.org or call us at 855-301-FAIR (3247), Monday through Friday, 9 am to 6 pm ET.